Centrally acting Analgesics Flashcards Preview

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Flashcards in Centrally acting Analgesics Deck (39):
1

Name Morphine Analogues.

Morphine, Heroin, Codeine.

2

Heroin.

Diamorphine.

3

Synthetic Derivatives of Morphine?

Methadone, Fentanyl, Pethidine, Pentazocine.

4

Stuff that act like opoids in the body?

Endorphins, Enkephanlins and Dynorphins.

5

Types of receptors affected by opoids?

Mu, Delta and Kappa.

6

How does morphine work?

Two components in action

Spinal - Inhibits dorsal horn pain transmission.
Supraspinal - Sends inhibitory impulses through descending pathways.

Inhibit release of excitatory transmitters from primary afferents.

7

What happens when a opoid receptor is activated?

Inhibition of Nuerotransmitter release.
Presynaptic - Inactivation of Ca2+ ion channels.
Post synaptic - Increased Potassium conductance (hyperpolarization).

Activation of descending gaba neurones.

8

Mu receptors.

Gets you high, addicted, sedated and can kill you (respiratory depression).

9

Kappa receptors

Modest analgesia with no addiction. Feel like shit and sedated.

10

Delta receptors.

Very small analgesic effect.

11

Pure Agonists at Mu and Kappa?

Morphine, Methadone, Fentanyl, Codeine.

12

Pure Antagonist?

Naloxone.

13

A mixed Agonist-Antagonist?

Buprenorphine.

14

Partial Agonist?

Pentazocine, Nalbuphine.

15

Effects of Opoids.

Analgesia, Sedation, Euphoria, Respiratory and Cough depression, Tranquility.

Nausea, Constipation, Low blood pressure, Urticaria and bronchoconstriction - release of histamines.

16

How can you clinically examine whether the patient may be suffering from an overdose of opoids?

Miosis - pinpoint pupils.

17

Codeine.

Weaker than morphine, mild-moderate pain and cough (depression of cough reflex).

18

Pure Agonists at Mu and Kappa?

Morphine, Methadone, Fentanyl, Codeine.

19

Pure Antagonist?

Naloxone.

20

A mixed Agonist-Antagonist?

Buprenorphine.

21

Partial Agonist?

Pentazocine, Nalbuphine.

22

Tramadol.

Weak acting at Mu. Spinal inhibition of pain. Re-uptake inhibitor of NA and 5-HT.

Oral, IM and IV.

23

How can you clinically examine whether the patient may be suffering from an overdose of opoids?

Miosis - pinpoint pupils.

24

Morphine.

Distributes widely in body and enters brain slowly. Cross to placenta, dependance in foetus.

In the liver it becomes more potent

25

Pethidine.

Fast. Moderate - severe pain.

26

Fentanyl.

Moderate - severe, Lipophilic.

27

Methadone.

Weak and longer lasting. Can give orally, Powerful, Cross tolerance with heroin.

28

Etorphine.

VERRRY powerful, more potent than morphine (1000 to 80000 times).

29

Tramadol.

Weak acting at Mu. Spinal inhibition of pain. Re-uptake inhibiitor of NA and 5-HT.

30

Why is tramadol easy to prescribe?

Less side effects, well tolerated and low abuse potential. Better for MODERATE pain compared to morphine.

31

Morphine.

Distributes widely in body and enters brain slowly. Cross to placenta, dependance in foetus.

32

How long would morphine last?

2-3 hours.

33

When will morphine be completely removed?

In one day.

34

Effects of Opioids in general?

Analgesia, Euphoria/Dysphoria, Respiratory depression (most common cause of death) and decreased gastric motility.

Relaxation, hypothermia, Hypotension, Reduced sex drive, Drying of secretion, flushed warm skin, Tranquilization.

35

Contraindications of Opioids?

Pregnancy, Head Injury, Pulmonary, hepatic or renal dysfunction.

36

Do not use a Pure Agonist with,

A weak partial agonist.

37

What's the difference between Dependance and Addiction?

Dependance is physical, Addiction is psychological.

Dependance lasts only for a few days whereas psychological can go on for years.

38

Naloxone.

Antagonist at all 3 receptors.Used to treat respiratory depression, precipitate withdrawal syndrome.

39

Morphine over dosage triad.

Pinpoint pupil, Coma, Respiratory depression